Generalized Anxiety Disorder Screener Research Articles

A single-arm pilot study of a brief cognitive-behavioral therapy for insomnia intervention among Japanese occupational therapy and physical therapy university students with sleep disturbances

ObjectiveTo evaluate the feasibility of the Sleep Health through University Student Habits (SHUSH) program, a brief sleep improvement intervention based upon principles of cognitive-behavioral therapy for insomnia (CBT-I) developed for Japanese university students.MethodsPretest-posttest, single-arm pilot study design with 3-month follow up was used to evaluate the feasibility of SHUSH. We developed then offered a 90-min sleep education class based upon the two-process model of sleep regulation, sleep restriction, stimulus control, and sleep hygiene. We recommended individualized sleep prescriptions (e.g., prescribed time to bed and prescribed time out of bed) from 11 days of daily sleep diary data. We then offered 15 min of individualized follow-up meetings each week for three consecutive weeks in person or online in which we supported adherence to sleep prescriptions. Fifteen university students with self-reported sleep disturbance (Insomnia Severity Index; ISI score ≥ 9) completed the SHUSH program. Participants were on average age 19.7 years old; nine were women, and they were students in occupational therapy and physical therapy. We assessed validated Japanese versions of sleep-related (e.g., ISI, Sleep hygiene practice scale; SHPS), mental health-related (e.g., Generalized Anxiety Disorder Screener) patient-reported outcomes (PROs) and daily sleep diary variables (e.g., sleep onset latency and sleep efficiency).ResultsComparing baseline and posttest data, a statistically significant difference was observed in insomnia symptom severity, daytime sleepiness, sleep hygiene practices, eveningness to morningness, anxiety, depression, sleep diary improvements (e.g., sleep onset latency, total time in bed, and sleep efficiency). Comparing posttest and 3-mo follow up data (n = 10), a statistically significant difference wasn't observed for most PRO effects. However, there was a statistically significant difference in ineffective sleep behaviors (i.e., SHPS-J). We did observe a rebound effect for some SHPS-J items.ConclusionSHUSH was developed as a brief cognitive-behavioral intervention for insomnia. SHUSH participants showed improvements on sleep-related and mental health-related PROs after 4 weeks of intervention. At 3 months follow-up sleep quality and mental health gains were maintained. SHUSH was a feasible program. Randomized controlled trials are needed to test treatment efficacy on sleep related and mental health related PROs in the future.

Prenatal Telepsychological Intervention for Preventing Anxiety: A Study Protocol.

Background: Anxiety is one of the most frequent disorders during the perinatal stage that is associated with adverse health effects in women and their babies. In spite of this, preventive interventions during this stage are scarce. A long-distance intervention carried out during pregnancy can be an effective and accessible resource to help improve women's emotional state. The objective of this study is to present and assess the effectiveness of a telepsychology cognitive-behavioral preventive intervention during pregnancy to manage anxiety. Methods: A random clinical trial will be carried out among pregnant women in Spain. The psychological intervention will take place via videoconference in seven weekly sessions, lasting one hour each, with groups of 6-8 pregnant women. Study outcomes will be collected via online questionnaires at five points in time: pre-intervention (baseline: t0), post-intervention (baseline: t1), follow-up at 1 month (t2), follow-up at 3 months (t3) and follow-up at 6 months (t4). The control group will receive usual pregnancy care (attendance at pregnancy follow-up consultations and information and answers to frequently asked questions provided by the midwife). Our primary hypothesis is that the intervention will decrease the frequency of women who present anxious symptomatology during pregnancy. The second objective is to analyze the effectiveness of this intervention to prevent depressive symptomatology during pregnancy, as well as postpartum anxiety and depressive symptomatology. The primary outcome measure is the difference in the mean anxiety score between the intervention and control groups assessed by the Edinburgh Depression Scale-Anxiety Subscale (EDS-3A), the State-Trait Anxiety Inventory (STAI) and Generalized Anxiety Disorder Screener (GAD-7) at the end of the intervention and at 1, 3 and 6 months postpartum. Generalized anxiety disorder (GAD) will be evaluated with the SCID clinical interview at the same time points. The secondary outcome will be determined by using the EPDS at the same time points. Conclusions: The results will determine whether a cognitive behavioral therapy applied via videoconference is well accepted by pregnant women, and if it is effective in preventing anxiety and emotional symptoms during the perinatal stage. If this intervention is an effective and useful resource among pregnant women, it can be implemented as a tool in Spanish healthcare.

Psychometric Evaluation of the Insomnia Severity Index in Nurses

ABSTRACT Objectives Examine psychometric properties of the Insomnia Severity Index (ISI) in a sample of nurses. Method In a sample of day shift nurses (N = 289), a confirmatory factor analysis (CFA), convergent and discriminant validity analyses, and a test–retest reliability analysis were performed. Results CFA showed that a two-factor model provided the best fit. The ISI had moderate to poor convergent validity with sleep diary parameters, and moderate convergent validity with the Sleep Condition Indicator (r = -.66), Pittsburgh Sleep Quality Index (r = .66), and PROMIS Sleep-Related Impairment measure (r = .67). The ISI demonstrated good discriminant validity with the measures Composite Scale of Morningness (r = −.27), Nightmares Disorder Index (r = .25), PTSD Checklist for DSM-5 (sleep items removed; r = .32), and Perceived Stress Scale (r = .43). The ISI had weaker discriminant validity with the PHQ-9 (r = .69) and Generalized Anxiety Disorder Screener (r = .51). The ISI demonstrated a good test–retest reliability (ICCs = .74–.88). Conclusions The ISI is a psychometrically strong measure for the assessment of insomnia severity in day shift nurses. Overlap with psychological symptoms, primarily anxiety and depression, suggests caution while interpreting these constructs.

Marijuana use among community-dwelling older adults: A population-based study.

There is a paucity of population-level data on marijuana use and mental health and functioning in older adults. We analyzed cross-sectional data (n=910) from a well-characterized cohort, the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study. MYHAT is an age-stratified random sample of the population age 65years and older from a small-town in the USA. Half the sample was female and half were over 75 (Mean age=77). Most participants were non-Hispanic White. Marijuana use was assessed by self-report and symptoms of mood disorders were screened using the modified Centers for Epidemiological Studies-Depression Scale and the Generalized Anxiety Disorder screener. Cognition was assessed by the Mini-Mental State Examination and a neuropsychological test battery; functioning using the OARS Activities of Daily Living and Instrumental Activities of Daily Living; and overall assessment using the Clinical Dementia Rating (CDR®). One in five MYHAT participants had a history of marijuana use and 5% reported recent use, primarily for pain (41%) and recreation/relaxation (37%). Recent use was associated with cigarette and alcohol use, symptoms of depression or anxiety, and impairments in attention. Twenty-percent of community-dwelling older adults living in a US state where recreational marijuana use is illegal had a history of marijuana use. Recent marijuana use was less common but, consistent with prior research, associated with other substance use and poorer mental health.

Translation, cultural adaptation, and validation of the PHQ-9 and GAD-7 in Kinyarwanda for primary care in the United States.

Depression and anxiety are significant health burdens that greatly impact the quality of life of refugees and migrants. In this study, we have translated and culturally adapted the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Screener (GAD-7) into Kinyarwanda and performed a validation study in a United States (US) primary care setting. A committee of seven experts including psychiatric and family medicine providers, health researchers, and trained medical interpreters translated and culturally adapted the PHQ-9 and GAD-7, and incorporated feedback from cognitive interviews with bilingual participants. The translated instruments were then tested in a cross-sectional validation study. Analyses include internal consistency, discriminant validity, principal component analyses, and confirmatory factor analyses. Analyses of 119 responses indicated overall good internal consistency with Cronbach's α of 0.85 (PHQ-9) and 0.92 (GAD-7). Both scales showed acceptable factor loadings between 0.44 and 0.90 in the principal component analyses and showed strong correlations with health-related quality of life and depression/anxiety symptoms measured with visual analog scales. Significantly higher scores for PHQ-9 and GAD-7 were shown among participants with known psychiatric conditions. PHQ-9 and GAD-7 demonstrated commendable applicability for Kinyarwanda-speaking patients in primary healthcare settings in the US. Our instruments can already be used in primary care settings and thus help to mitigate health disparities. Future research should further validate our tool against gold-standard diagnostics in larger, geographically diverse samples.

Perceived social support and longitudinal trajectories of depression and anxiety in World Trade Center responders

PurposeWhile severely distressing events are known to affect mental health adversely, some survivors develop only short-lived or no psychiatric symptoms in the aftermath of a disaster. In the WTC Health Program General Responder Cohort (WTCHP GRC) we examined whether social support was protective against the development of depression or anxiety symptoms after the 9/11 WTC attacks and explored in a subsample whether trait resilience moderated this relationship.MethodsWe analyzed data from 14,033 traditional and 13,478 non-traditional responders who attended at least three periodic health monitoring visits between 2002 and 2019. Linear mixed-effects models were used to examine depression (Patient Health Questionnaire-9; PHQ-9) and anxiety (Generalized Anxiety Disorder screener; GAD-7) scores. In a subsample of 812 participants, we also assessed if the association between social support and symptoms was moderated by an individual’s trait resilience level (Connor-Davidson Resilience Scale, CD-RISC).ResultsFor both traditional and non-traditional responders, perceived social support around 9/11 was associated with lower levels of depressive (β = − 0.24, S.E. = 0.017, z = − 14.29, p < 0.001) and anxiety symptoms (β = − 0.17, S. E. = 0.016, z = − 10.48, p < 0.001). Trait resilience scores were higher in responders with at least one source of social support during the aftermath of 9/11 compared to those without (mean 71.56, SD 21.58 vs mean 76.64, SD 17.06; β = 5.08, S.E. = 0.36, p < 0.001). Trait resilience moderated the association between social support and depressive (p < 0.001) and anxiety trajectories (p < 0.001) for traditional responders.ConclusionOur findings suggest that perceived social support around a severely distressing event may have long-term protective effects on symptoms of depression and anxiety.

The Relationship between Anxiety, Visual Function, and Symptomatology in University Students.

Mental health concerns have emerged at the university level, with the psychological well-being of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 ± 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test ("no anxiety" and "anxiety" groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorders.

Early-life participation in cognitively stimulating activities and risk of depression and anxiety in late life.

Early-life stressful experiences are associated with increased risk of adverse psychological outcomes in later life. However, much less is known about associations between early-life positive experiences, such as participation in cognitively stimulating activities, and late-life mental health. We investigated whether greater engagement in cognitively stimulating activities in early life is associated with lower risk of depression and anxiety in late life. We surveyed former participants of the St. Louis Baby Tooth study, between 22 June 2021 and 25 March 2022 to collect information on participants' current depression/anxiety symptoms and their early-life activities (N = 2187 responded). A composite activity score was created to represent the early-life activity level by averaging the frequency of self-reported participation in common cognitively stimulating activities in participants' early life (age 6, 12, 18), each rated on a 1 (least frequent) to 5 (most frequent) point scale. Depression/anxiety symptoms were measured by Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Screener (GAD-7). We used logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) of outcome risk associated with frequency of early-life activity. Each one-point increase in the early-life composite cognitive activity score was associated with an OR of 0.54 (95% CI 0.38-0.77) for late-life depression and an OR of 0.94 (95% CI 0.61-1.43) for late-life anxiety, adjusting for age, sex, race, parental education, childhood family structure, and socioeconomic status. More frequent participation in cognitively stimulating activities during early life was associated with reduced risk of late-life depression.

Changes in anxiety in the general population over a six-year period.

Anxiety is a frequent condition in patients and in the general population. The aim of this study was to investigate changes in anxiety over time and to test several psychometric properties of the Generalized Anxiety Disorder Screener (GAD-7) from a longitudinal perspective. The GAD-7 was included in an examination with two waves, six years apart. The study sample (n = 5355) was comprised of representatively selected adults from the general population with a mean age of 57.3 (SD = 12.3) years. During the 6-year time interval, anxiety increased significantly from 3.28 ± 3.16 (t1) to 3.66 ± 3.46 (t2). Confirmatory factor analyses proved the longitudinal measurement invariance of the GAD-7. Reliability of the GAD-7 was established both for the cross-sectional and the longitudinal perspective. The test-retest correlation was r = 0.53, and there were no substantial sex or age differences in these coefficients of temporal stability. The mean changes in anxiety were similar for males and females, and there was no linear age trend in the changes measured by the GAD-7. Changes in anxiety over the 6-year period were correlated with changes in satisfaction with life (r = -0.30), bodily complaints (r = 0.31), and the mental component of quality of life (r = -0.48). The GAD-7 is a suitable instrument for measuring changes in anxiety. Age and gender have only minor significance when interpreting change scores.

Behavioral and psychological diagnosis for universities students after the corona pandemic closures

With the coronavirus's rapid spread, most countries have taken preventive measures to limit this spread. Therefore, this paper aims to explore university students' behavioral and psychological variables. To achieve this, the researchers used the descriptive survey approach to the 3,152 Jordanian university students (2,194 female and 1,058 male). We put the Generalized Anxiety Disorder screener GAD-7 and behavioral variables an electronic questionnaire using (Google Forms). To achieve the study's objectives, we used: means, standard deviations, frequencies, percentages, Pearson correlation coefficient, and Chi-square tests with a confidence level of 95% (p&amp;lt;0.05). The study results revealed that (66.34%) don’t do regular physical activity, and there were statistically significant differences between males and females in the practice of physical activities in favor of males. In addition, (64.47%) of the study sample spent (5-10) hours, and (26.6%) spent more than (10) hours on social networking sites. Also, (40.03%) of the study sample suffers from fat accumulation in the waist, pelvis, and thighs. There were also (60.32%) who suffered from sleep disorders. In addition, there are overlapping relationships between the study variables (anxiety level, sleep duration, time spent on social networks, physical activities, and body shape).

Effects of Elderly Gymnastics and Reflexology Program on Anxiety Among Elderly Using The Generalized Anxiety Disorder Screener (GAD-7)

The purpose of this study is to evaluate the impact of reflexology and elderly exercise as a combination intervention on lowering anxiety levels in seniors. The sample is a population that meets the inclusion criteria. The number of targeted samples is obtained using the average difference formula randomly. Number of respondents are 15 who fullfil the inclusion criteria aged 60-72 . The program package consists of reflexology combined with elderly exercises: Reflections are carried out: 2 times a week for 5 weeks, rlderly excersises is s is carried out 2 times a week. In measuring anxiety, the use the Generalized Anxiety Disorder Screener (GAD-7) has been proven to have high reliability and validity and identifies possible cases of generalized anxiety disorder and assesses the severity of symptoms. The respondents consist of 2 male (13.3%) and 13 female respondents (86.7%) with average age was 63.1 ± 2.2 and gender was differentiated into men with an average of 62.5 ± 3.5 then women with an average of 63.2 ± 2.1 then it is also known that the average level of anxiety before the intervention was 2.53 ± 3.52 with a 95% confidence level (95% CI) between 0.58 - 4.48 and the average level of anxiety after the intervention was 0.67 ± 1, 17 with a 95% confidence level (95% CI) between 0.02 – 1.30. into catagories 12 people (80%) had normal anxiety levels before the intervention, 2 people (13.3%) had mild, and 1 person (6.7%) had moderate and no severe. Wilcoxon test results, 7 respondents decreased anxiety levels, 3 respondents increased anxiety levels, and 5 respondents' anxiety remained the same as before undergoing the program package but statistically not significant&#x0D; Conclution: The resulth are obtained was 2,53 ± 3.52, and after the intervention, it was obtained 0,67 ± 1.17 for the level of anxiety using GADS by catagories measuring before and after was 6.43%. The level of mild and moderate anxiety after the intervention changed to 3.33%.

A cross-sectional study of alcohol, opioid use, and anxiety in agriculturally based occupations.

Although there are many studies that have examined substance use and mental health concerns in rural areas, there is a paucity of research related to the prevalence of substance use and mental well-being in agriculturally based occupations. This study aimed to determine the prevalence of alcohol and opioid misuse and anxiety among adults in agriculturally based occupations in the rural Midwest and to determine the risk factors for alcohol misuse. Data were collected via mailed surveys with 1,791 surveys returned. Participants completed the Alcohol Use Disorder Identification Test, the Drug Abuse Screening Test-1, the Generalized Anxiety Disorder Screener, and reported demographic data. Multivariable logistic regression was used to examine factors associated with alcohol misuse. Younger age, male, not married, agriculturally based workers were significantly associated with alcohol misuse. For opioid use, the highest prevalence rate (10%) was found among direct agricultural workers who were not married and in the age group 19-39. The highest anxiety prevalence rate was found in participants aged 19-39 (15.5%) who also scored in the highest level of alcohol misuse with a prevalence rate of 27.9%. Future research is suggested in the areas of gender identity and anxiety in agricultural populations and agriculturally based occupations as protective factors for opioid misuse.

Avaliação da saúde mental em estudantes de Medicina durante suspensão das atividades acadêmicas na pandemia

Abstract: Introduction: During the Sars-CoV-2 pandemic, social distancing measures and various other stress factors may have been responsible for impacts on medical students’ mental health. Objective: The purpose of this study is to describe the mental health status of medical students at a college in northeastern Brazil, in the context of the COVID-19 pandemic, investigate symptoms of anxiety and depression, and assess resilience, as well as its possible associated factors. Methodology: A cross-sectional qualitative and quantitative method was used. Data were collected using an online questionnaire among students enrolled in the medical school; data were further processed using quantitative and qualitative statistical analysis separately. The following scales were applied: Generalized Anxiety Disorder Screener (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Wagnild and Young’s Resilience Scale (RS-25). Results: About one-third of the students lived with moderate or severe anxiety symptoms, almost half had moderate to severe depressive symptoms, and more than half were classified as having low or moderately low resilience. Conclusion: Our findings highlight the difficulty in maintaining high levels of resilience and that the presence of depression or anxiety would be related to lower resilience scores in medical students during remote education. Further studies are needed to establish a causal link with the pandemic.

Mental health assessment of the Brazilian LGBTQIAP+ population during the COVID-19 pandemic: a cross-sectional study.

To investigate the association between the frequency and associated factors of non-psychotic mental disorders and anxiety symptoms in a Brazilian LGBTQIAP+ sample. Cross-sectional study, conducted from September to October 2020 using an online questionnaire, with instruments for sociodemographic characterization, the Generalized Anxiety Disorder Screener and the Self-Report Questionnaire. The analysis was performed using the Chi-square and Fisher's Exact tests. Poisson regression with robust variance was performed to estimate the effect of sociodemographic variables on mental health. Positive screening for anxiety and non-psychotic disorders were identified in 85.2% and 60.2% of the participants, respectively. Younger age groups, who professed some religion, only had access to public health, and presented with medical conditions showed a higher risk for non-psychotic mental disorders. Individuals under 30 (1.33, 95%, CI = 1.17-1.52) presented a high risk for anxiety symptoms. The prevalence of anxiety and non-psychotic disorders during the COVID pandemic was high. Implementation of health policies and interventions targeting identified risk factors is recommended.

Investigating adolescent mental health of Chinese students during the COVID-19 pandemic: Multicenter cross-sectional comparative investigation.

The coronavirus disease 2019 (COVID-19) pandemic has caused significant challenges for adolescent mental health. To survey adolescent students in China to determine the effects of the COVID-19 pandemic on their mental health. A multicenter cross-sectional comparative investigation was conducted in March 2022. We collected demographic information and survey data related to the COVID-19 pandemic. The Patient Health Questionnaire-9 and Generalized Anxiety Disorder Screener scales were used for objective assessment of depression and anxiety. We collected mental health questionnaires from 3184 students. The investigation demonstrated that adolescents most strongly agreed with the following items: Increased time spent with parents, interference with academic performance, and less travel. Conversely, adolescents most strongly disagreed with the following items: Not having to go to school, feeling an increase in homework, and not socializing with people; 34.6% of adolescents were depressed before COVID-19, of which 1.9% were severely depressed. After COVID-19, 26.3% of adolescents were prone to depression, of which 1.4% were severely depressed. 24.4% of adolescents had anxiety before COVID-19, with severe anxiety accounting for 1.6%. After COVID-19, 23.5% of adolescents were prone to anxiety, of which 1.7% had severe anxiety. Chinese adolescents in different grades exhibited different psychological characteristics, and their levels of anxiety and depression were improved after the COVID-19 pandemic. Changes in educational management practices since the COVID-19 pandemic may be worth learning from and optimizing in long-term educational planning.

Validation of the generalized anxiety disorder screener (GAD-7) in Cypriot pregnant and postpartum women

BackgroundAnxiety is increasingly acknowledged as a common mental health issue during the perinatal period. Its prevalence as well as the associated adverse effects constitute screening imperative. This study evaluates the psychometric properties and underlying factor structures of a Greek version of GAD-7 among pregnant and postpartum women (up to 6 months) in Cyprus.MethodsThis study was conducted from June to December 2020. A total of 457 Cypriot women in the perinatal period (222 pregnant and 235 postpartum) were surveyed. The assessment included anxiety (GAD-7) and depression (EPDS), and psychosocial factors related with anxiety. The internal consistency and factor structure of GAD-7 were evaluated using reliability coefficients, Cronbach’s Alpha and McDonald's Omega, and factor analysis, both Exploratory as well as Confirmatory.ResultsGAD-7 demonstrated good internal consistency (α = 0.907; Ω = 0.909). Horn's parallel analysis indicated a single factor as the most appropriate. CFA using the standard ML method indicated a good model fit, χ2 = 21.207, p = 0.096; CFI = 0.999; SRMR = 0.027. More studies are needed to determinate the cut-off point and the maximisation of the scale’s sensitivity and specificity in pregnant and postpartum Greek Cypriot women.ConclusionsGAD-7 is a valid and reliable measure and healthcare professionals should utilize GAD-7 as a standard instrument for the screening of anxiety symptoms in pregnant and postpartum Greek Cypriot women.

Safety, effectiveness and tolerability of sublingual ketamine in depression and anxiety: A retrospective study of off-label, at-home use.

Intravenous and intranasal ketamine have been shown to be effective therapeutic options in patients suffering from treatment-resistant depression (TRD). The use of sublingual (SL), rapid dissolve ketamine tablets (RDT) offers a novel approach for delivery for mental health indications. This study assessed the effectiveness and safety of self-administration of off-label, SL, rapid dissolve ketamine tablets (RDT) at-home for depression and anxiety. Intake scores on the Generalized Anxiety Disorder Screener (GAD-7) and Patient Health Questionnaire (PHQ-9) were compared to scores after treatments of three doses of ketamine RDT, and after six doses of ketamine RDT. After three doses of SL ketamine, 47.6% of patients showed a significant decrease in PHQ-9 scores, and 47.6% of patients showed a significant reduction in GAD-7 scores. Reduction rates were higher in those patients who completed a clinically recommended six doses of RDT ketamine. This study demonstrates that SL ketamine is a novel, safe, and effective treatment for TRD and treatment-resistant anxiety. SL ketamine offers an alternative therapeutic approach to IV ketamine when treating those with TRD.

Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: Comparisons between countries and with pre-pandemic data

BackgroundThe COVID-19 pandemic was a significant threat to perinatal mental health. This study examined differences in clinically significant depression, anxiety, and co-morbid symptoms among pregnant and postpartum women across several countries and compared prevalence of perinatal depression and anxiety before and during the pandemic in each participating country. MethodsParticipants were 3326 pregnant and 3939 postpartum women (up to six months postpartum) living in Brazil, Chile, Cyprus, Greece, Israel, Portugal, Spain, Turkey, and the United Kingdom. An online survey was completed between June 7th and October 31st 2020, and included the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Screener (GAD-7). The pre-pandemic studies were identified through literature review. ResultsPrevalence of clinically significant depression (EPDS≥13), anxiety (GAD-7 ≥ 10), and co-morbid (EPDS≥13 and GAD-7 ≥ 10) symptoms was 26.7 %, 20 % and 15.2 %, in pregnant women, and 32.7 %, 26.6 % and 20.3 %, in postpartum women, respectively. Significant between-country differences were found in all mental health indicators in both perinatal periods. Higher levels of symptoms were observed during (versus before) the pandemic, especially among postpartum women. LimitationsParticipants were mostly highly educated and cohabiting with a partner. The online nature of the survey may have limited the participation of women from vulnerable socio-economically backgrounds. ConclusionsOur findings expand previous literature on the negative impact of the COVID-19 pandemic on perinatal mental health, by highlighting that this may be influenced by country of residence. Mental health care policies and interventions should consider the unique needs of perinatal women in different parts of the world.

Work coping, stress appraisal, and psychological resilience: Reaction to the COVID-19 pandemic among health care providers.

Objective: This study examined the relationship between perceived stress appraisals and coping style during the COVID-19 pandemic, resulting distress reaction and effects on work engagement. Method: The sample (N = 423) was 78.6% female with average age and education of 38.5 and 18.4 years, respectively. Most respondents reported working in psychology/neuropsychology (31.7%) and rehabilitation/other therapies (29.7%). Surveys were distributed via Qualtrics among health care providers via listservs and referral emails from medical providers. Measures included: the Brief COPE Inventory, Work and Well Being Survey (UWES), Stress Appraisal Measure (SAM), Generalized Anxiety Disorder Screener (GAD-7), and the Screening Tool for Psychological Distress (STOP-D). Results: Health care workers endorsing problem-focused coping styles had lower levels of perceived threat and higher levels of perceived control in their response to the pandemic. Problem-focused coping was negatively associated with anxiety and depression in reaction to the pandemic when compared with health care workers who endorsed an emotion-focused coping style. Higher stress appraisal in response to perceived threat from the pandemic was not associated with lower work engagement or enthusiasm. Conclusions: Findings support the impact of coping style on psychological distress and work engagement during pandemic, with implications that these factors may be important considerations for mitigation of distress and burnout for health care workers during times of high stress. Initiatives to improve resiliency and wellness in health care workers may examine modifiable interventions for coping style. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement This study suggests that, among health care workers, using a problem focused coping style in response to COVID-19 pandemic stress mitigates experience of psychological distress and burnout. Initiatives that focus on modifiable interventions for coping styles may improve wellness in health care workers during environments of high stress, such as a chronic pandemic state. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Youth Aware of Mental Health (YAM) Program With Texas Adolescents: Depression, Anxiety, and Substance Use Outcomes.

Objective: To determine the state of mental health problems among a general youth population and assess whether the Youth Aware of Mental Health (YAM) intervention can improve symptoms of depression and anxiety.Methods: We implemented YAM with a cluster quasi-experimental study design from August 2017 through June 2019 in 29 middle schools and high schools in North Texas. Students completed the Quick Inventory of Depressive Symptomatology, Adolescent version; the Generalized Anxiety Disorder Screener; and additional substance use questionnaires before YAM delivery and 3-6 months after implementation. Multilevel models, with students nested within schools, were used to model difference scores of depression and anxiety, controlling for various student-level and school-level characteristics. Missing data were imputed during analysis. Sensitivity analyses were performed on non-imputed data.Results: Among 3,302 adolescents at pre-test, 27% had moderate-to-severe depression, 22% had moderate-to-severe anxiety, and 4% expressed suicidal ideation. We found that on average, compared to those who had no depression at pre-test, depression decreased at post-test by (a) 4.62 units (P < .05) for those who had severe to very severe depression at pre-test, (b) 2.92 units (P < .0001) for those who had moderate depression at pre-test, and (c) 1.5 units (P < .001) for those who had mild depression at pre-test, controlling for all other factors in the model. Similar significant decreases were observed in anxiety, controlling for student-level characteristics.Conclusions: These findings demonstrate the effectiveness of YAM in reducing symptoms of depression and anxiety among adolescents in North Texas.